UPDATE: The decision to close Queensland's main tuberculosis treatment centre at Brisbane's Princess Alexandra Hospital is an "absolute disaster", according to one of the state's leading respiratory physicians.

This afternoon, after brisbanetimes.com.au revealed there were plans to close the centre, a spokesman for Health Minister Lawrence Springborg confirmed the impending closure.

“Consultation has commenced on a process to devolve the functions of the TB Coordination Centre out to Hospital and Health Boards in relevant areas of the state,” the spokesman said.

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The spokesman said health decision-making worked more effectively in local areas and that was why the review was under way.

“This is consistent with this government's approach that local decisions can be better made in local settings, not in centralised arrangements,” he said.

“This approach is consistent with the way these services are delivered in other states, such as New South Wales and Victoria.”

The decision was not linked to Premier Campbell Newman’s election campaign promise in February to spend $42 million over four years to set up an Australian Institute of Tropical Health to study dengue fever, tuberculosis, rabies, and Hendra virus, the spokesman said.

The Queensland Tuberculosis Control Centre treats 240 existing TB cases and up to half of the 200 new cases in the state each year.

On Tuesday, Queensland Health asked for a business case to wind up the centre, which sits on Cornwall Street at Buranda at the PA Hospital.

Under the Queensland Health plan, the resources from the facility would be deployed to regional centres at Cairns, Rockhampton, Toowoomba and Townsville.

When told of the plan this morning, Mater Hospital director of medicine Simon Bowler, one of Queensland's most senior respiratory physicians, said the proposal would backfire badly.

"It would be an absolute disaster," Dr Bowler said.

"TB management is everybody's business, because if TB management is not done well, particularly if there is not a governance and surveillance over what is happening, then you get into the sort of situations that they have in India where they have virtually reached the point where TB is untreatable because the bug is so resistant no antibiotics work."

Dr Bowler said Queensland did not have Indian health conditions and when proper oversight was given, TB treatment was so easy "a gardener could do it".

"The problems arise when people get lost, people don't take medication, and in particular if they take 'bits and pieces' of medication," he said.

"Then you have major issues with the development of resistance.

"One of the things that this clinic does is maintain a list of people who are on treatment, follows up what is happening and provides a strategic overview for Queensland."

Dr Bowler said the first he had heard of the plans was when brisbanetimes.com.au contacted him for comment.

"I think it would be a very bad idea and I think it would be a false economy in the long run," he said.

Despite Queensland having Australia's lowest rate of tuberculosis, there was still 200 new cases each year in Queensland, a senior officer in Queensland Health confirmed.

"It is not a 'disappeared disease' as people think. We have around 200 new cases a year in Queensland," the source, speaking on the condition of anonymity, said.

"So it is not a disease that is gone. It is not a disappearing disease."

The Queensland Tuberculosis Control Centre has a budget in the vicinity of $2 million to $3 million a year and has 50 staff, including researchers, analysts, doctors, 10 nurses, a nursing director and administration staff.

A senior source at the centre said all Queenslanders should be aware of the plans because it was seeing half of the 200 new cases and treating 240 existing cases a year.

The QTBCC has direct links with the micro-bacterial lab that tests most tuberculosis cases in Queensland.

"We are often the first to know about any positive case of TB," the source said.

"We actually tell the clinicians they have a confirmed TB case before they even know."

The centre treats tuberculosis – each TB patient has a nursing case manager – but also offers expert advice to respiratory physicians, the source said.

The source said most cases of tuberculosis in Queensland were in north and southeast Queensland.

"And we would see, directly, one third to one half of those cases here," the source said.

The major problem with the workload being sent back to the regional offices was maintaining the patient follow-up services, the source said.

"This has been forgotten from people's memories, in the 1980s TB became a major problem in New York," the source said.

"The TB rates in New York reached developing-country standards and that was largely because there was no follow-up services when people left hospital.

"They found that in a particular hospital in Harlem, 89 per cent of people had no follow-up after the time they were discharged."

The source said this level of care followed health cutbacks during the administration of then-United States president Ronald Reagan.

"Now during this time there were lots of attempts to rationalise spending, lots of cuts to public health," the source said.

"All the community health and referral processes - where these people are normally referred to as outpatients - were cut.

"But they ultimately had to spend million and millions of dollars to revitalise their health system.

"...what New York showed is that if you don't have monitoring occur, they saw the problem within five years of the breaking down of all these services.

"Now, in a setting like Queensland, if that was to go wrong, it may take 20 years before you see it, because we don't have the HIV problem that fuels it."

However, the source warned that problems with tuberculosis were now emerging in drug-resistant forms, mainly from people who caught the disease overseas.

Tuberculosis was "endemic and active in Papua New Guinea" and high rates in drug-resistant forms and more dangerous forms were emerging, the source said.

"The case we have of XDRT (extremely drug resistant tuberculosis) is in that cross-border region of PNG and Thursday Island," the source said.

Australia has the lowest rates of TB in the world and Queensland has the lowest rate in Australia.

44 comments

This decision is absolutely insane.This service also looks after health care workers who have been unknowingly exposed to patients with TB, as I was several years ago.It is not a resource that Brisbane can do without.

Commenter

Rebecca

Location

Brisbane

Date and time

August 01, 2012, 1:50PM

"Under the Queensland Health plan, the resources from the facility would be deployed to regional centres at Cairns, Rockhampton, Toowoomba and Townsville."

So essentially the plan is to move the Tropical diseases and TB expertise to the Tropical areas then?

Just explain to me why that is a bad thing? (Please read the article first though)

Commenter

Carstendog

Date and time

August 01, 2012, 2:40PM

@Carstendog if you read the article, you would have read that the centre treats 200 out 240 cases of TB per year. Given that SE Queensland has the largest population in the state it is safe to assume that it also has the largest number of cases in the state.

Furthermore, you would have read the situation in New York in the 1980s. As you may know New York (City or State) is not located in the tropics, but TB is still an issue. That says to me that TB is not limited purely to tropical areas, like you are trying to suggest.

Finally, a centrally located centre has to be more cost effective than splitting it up into smaller centres where there will be duplication of roles and responsibilities. Suddenly you need a director for each centre, rather than one director for one centralized centre. Suddenly you have researchers needing to travel all over the state to share their latest findings with researchers located in another centres. That all sounds pretty expensive to me, certainly sounds like a lot more than the 2 to 3 million it costs at the moment.

Commenter

Les

Date and time

August 01, 2012, 4:00PM

@Carstendog if you read the article, you would have read that the centre treats 100 new cases (half of all cases in QLD) and 240 existing cases of TB per year. Given that SE Queensland has the largest population in the state it is safe to assume that it also has the largest number of cases in the state. No doubt they also provide advice to other areas of the state.

Furthermore, you would have read the situation in New York in the 1980s. As you may know New York (City or State) is not located in the tropics, but TB is still an issue. That says to me that TB is not limited purely to tropical areas, like you are trying to suggest.

Finally, a centrally located centre has to be more cost effective than splitting it up into smaller centres where there will be duplication of roles and responsibilities. Suddenly you need a director for each centre, rather than one director for one centralized centre. Suddenly you have researchers needing to travel all over the state to share their latest findings with researchers located in another centres. That all sounds pretty expensive to me, certainly sounds like a lot more than the 2 to 3 million it costs at the moment.

Commenter

Les

Date and time

August 01, 2012, 4:06PM

Carstendog I took your advice and read the article - twice...Then I availed myself of Prof. Google's services, to find among other things, to my "total surprise", TB is not confined to tropical regions...So, could this explain why I'm thinking it's not a totally good thing to close the PA resource?...One other thing, didn't the "Hendra virus", as the name would suggest, first surface in a Brisbane suburb.

Commenter

Peter Allan

Location

Brisbane

Date and time

August 01, 2012, 4:42PM

"The source said most cases of tuberculosis in Queensland were in north and southeast Queensland.

"And we would see, directly, one third to one half of those cases here," the source said".

Really you went to google and yet this was in the article! Most cases are from North Queensland and the patients have to come to the Hospital from other parts of Queensland......but don't let that get in the way of an anti-LNP rant

Commenter

Carstendog

Location

Townsville

Date and time

August 01, 2012, 5:57PM

"....in north AND southeast Queensland", so the question remains, why close the PA centre?...As for Dr Bowler's input - not important, obviously just an anti-LNP rant.

Commenter

Peter Allan

Location

Brisbane

Date and time

August 01, 2012, 9:55PM

This is a fantastic idea Canbull, I mean the chance of me getting TB is very low so why the hell should my tax dollars go into some rubbish like this? You can obviously find savings by splitting it up so do it, that bloody doctor is just trying to feather his own nest anyway, bloody academics!

Keep at it Canbull, you truly are an inspirational leader.

Commenter

Abe

Date and time

August 01, 2012, 1:57PM

Well done Abe. This ignorance is what allows things like health care to diminish. The attitude "I don't have it so why should I care?" really shows your character. Any sort of illness, disability or disease should be treated with seriousness and respect. This doctor may well be 'feathering' his nest but the point here is that patient care is being reduced in quality and how it is delivered. I guess if the message delivered by the government is, don't get sick because if you do help is not readily available.